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. 2021 Jul 31;73(1):69.
doi: 10.1186/s43044-021-00193-2.

Acute pulmonary embolism in a patient with hepatitis C virus infection and hepatocellular carcinoma: a case report

Mahmoud Abdelnabi  1 , Yehia Saleh  2 , Abdallah Almaghraby  3 , Özge Özden Tok  4 , Hoda Abdelgawad  2 , Sherif Abd ElSamad  5
Affiliations

Acute pulmonary embolism in a patient with hepatitis C virus infection and hepatocellular carcinoma: a case report

Mahmoud Abdelnabi et al. Egypt Heart J. .

Abstract

Background: Cardiac metastases in hepatocellular carcinoma patients are infrequently encountered and usually associated with a very poor prognosis.

Case presentation: Hereby, we report a case of an acute pulmonary embolism (PE) on top of HCC with direct cardiac invasion to the right atrium (RA) through the inferior vena cava with another metastasis to the right ventricular apex in the form of highly mobile cauliflower mass protruding through the tricuspid valve into RA and nearly obliterating right ventricular outflow tract in a multi-centric hepatocellular carcinoma patient.

Conclusion: Acute dyspnea in a patient with a long history of hepatitis C virus infection raises the suspicion of acute PE due to either hypercoagulable state induced by malignancy or by cardiac extension of the tumor which usually carries high mortality rates. To the best of our knowledge, this case is the first case in the literature to show cardiac metastases in HCC with two different pathological mechanisms.

Keywords: Echocardiography; Hepatitis C virus; Hepatocellular carcinoma; Pulmonary embolism.

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Conflict of interest statement

All the authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
a–d Transthoracic Echocardiography revealing a large solid mass extending through IVC to RA with another highly mobile cauliflower mass at the RV apex occupying The RV cavity, protruding into RA through TV and nearly obliterating RVOT into the pulmonary artery
See this image and copyright information in PMC

References

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